HomeMy WebLinkAboutFOUNDATION ONLY AFFIDAVITPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-3553 Fax: (772) 462-1578
Foundation only affidavit for residential accessory structures
Permit No.
I '. understand that I am proceeding with the
foundation my own risk. I understand that there is no assurance that my permit
for the entire structure will be granted and that I accept full responsibility for any
changes that are required in the design including but not limited to elevated 18
inches above the crown of the road or above flood elevation. The foundation must
meet the requirements of the engineered drawing submitted at the time of
permitting. Please be advised minimum required setbacks must be met for any
future structure in accordance with the applicable zoning district.
Co ractor/Owner Builder SCANNED
BY
St. Lucie County
STATE OF FLORIDA N'
COUNTYOF LttCu—�
The forgoing instrument
was
acknowledged before me
This _ j__ day of ZO y
(Name of person cknow edging)
(Signature of Notary Public- State of Florida)
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.6 20)7,1 (Seal)
ELLEN VAUGHN
®State of Florida -Notary Public
•= Commission k GG 270079
My Commission Expires
October 22, 2022..